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NPI Code Detail

MEDICARE: SHARON R JOHNSON MS,CCC-SLP

MEDICARE:   SHARON R JOHNSON  MS,CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1310-154WI

General Provider Information

NPI Number : 1083730402
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON R JOHNSON MS,CCC-SLP
Provider Business Mailing Address
First Line : 3541 PLOVER RD
Second Line :
City : WISCONSIN RAPIDS
State : WI
Zip : 54494-2155
Country : US
Telephone Number : 715-423-5423
Fax Number : 715-423-1532
Provider Business Practice Location Address
First Line : 825 WHITING AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-5246
Country : US
Telephone Number : 715-346-1516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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Directions to “ SHARON R JOHNSON MS,CCC-SLP” Practice Location

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